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Addis-Kakowski test values
Last reviewed: 06.07.2025
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Reference values: erythrocytes - 0-0.5×10 6 /day, leukocytes - up to 2×10 6 /day, cylinders - up to 2×10 4 /day.
To calculate the number of cellular elements excreted in urine per day and the true ratio of different forms of cellular elements, the Addis-Kakovsky test is carried out. The Addis-Kakovsky urine test, as well as the Nechiporenko test, is used in clinical practice for the following purposes:
- detection of hidden leukocyturia and hematuria and assessment of their degrees;
- dynamic monitoring of the course of the disease;
- to clarify the question of the predominance of leukocyturia or hematuria.
Determining the degree of prevalence of leukocyturia or hematuria is important in making a differential diagnosis between glomerulonephritis and pyelonephritis. In chronic pyelonephritis, the content of leukocytes in daily urine usually increases significantly (up to 3-4×10 7 or more) and they prevail over erythrocytes. An increase in the number of leukocytes in daily urine is often observed in the first, inflammatory stage of chronic pyelonephritis, while with the development of the second, sclerotic stage, pyuria decreases. An increase in pyuria during this period indicates an exacerbation of the inflammatory process. It is always necessary to remember that the results of the study may change due to secondary hematuria caused by urolithiasis, often combined with chronic pyelonephritis. In patients with glomerulonephritis, erythrocytes in the urine prevail over leukocytes.
The Addis-Kakovsky test may have some significance for assessing the functional state of the kidneys in hypertension. In hypertension without renal arteriolosclerosis, the test results are normal; with the addition of pronounced renal arteriolosclerosis, dissociation is observed between the content of leukocytes and erythrocytes towards an increase in the latter, while the content of leukocytes remains normal.